title: Outcome of patients with haemodynamically stable ventricular tachycardia treated with an implantable cardioverter-defibrillator.
abstract: BACKGROUND
  The benefit of implantable cardioverter defibrillator (ICD) therapy in patients with haemodynamically stable ventricular tachycardia (VT) is not well documented.
  
  
  METHODS
  In this single-centre observational study, we examined the medical records of 53 patients (48 men, mean age 66 +/- 1 years) treated with an ICD. The patients were classified into four groups with comparable clinical and electrophysiological characteristics, as follows: patients presenting with (a) stable VT, (b) unstable VT, (c) cardiac arrest, and (d) non-sustained VT and induced sustained VT or ventricular fibrillation (VF) on electrophysiological study. Kaplan-Meier event-free survival curves were constructed and the incidence of appropriate device therapy was compared among the four groups.
  
  
  RESULTS
  All patients had structural heart disease with a mean ejection fraction of 32.5 +/- 1.3%. During a mean follow-up period of 35.5 +/- 2.7 months, event-free survival was similar in the four groups. However, appropriate device therapy occurred in 9 (81.8%) patients with stable VT, in 6 (44.4%) patients with unstable VT, in 2 (33.3%) patients with cardiac arrest and in 6 (33.3%) patients with non-sustained VT and induced sustained VT/VF. Compared to the total patient cohort, appropriate therapy was significantly (p = 0.024) more common in patients presenting with stable monomorphic VT. In 2 (22.2%) of these patients, the tachycardia rate was faster than the presenting VT.
  
  
  CONCLUSIONS
  High recurrence rates are observed in patients with structural heart disease and stable VT, with a considerable proportion being faster than the presenting VT. ICD therapy is beneficial and should be offered in these patients.
authors.affiliation: Department of Cardiology, University of Ioannina, Greece. thkolet@cc.uoi.gr
authors.forename: Theofilos M
authors.initials: TM
authors.lastname: Kolettis
authors.forename: Vassilis D
authors.initials: VD
authors.lastname: Krikos
authors.forename: Dimitris
authors.initials: D
authors.lastname: Apostolidis
authors.forename: Katerina K
authors.initials: KK
authors.lastname: Naka
authors.forename: Christos S
authors.initials: CS
authors.lastname: Katsouras
authors.forename: Eleni
authors.initials: E
authors.lastname: Sourla
authors.forename: Lampros K
authors.initials: LK
authors.lastname: Michalis
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017147:Defibrillators, Implantable; D018572:Disease-Free Survival; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents